Key result
Body mass index had a negative correlation with the severity of coronary artery disease (p≤0.001), whereas waist-to-hip ratio had a positive correlation with disease severity (p=0.03).
Why the study?
Does body mass index or waist-to-hip ratio correlate with the severity of coronary artery disease in patients undergoing coronary angiography?
Cross-Sectional (n=414)
Does body mass index or waist-to-hip ratio correlate with the severity of coronary artery disease in patients undergoing coronary angiography?
p-value: p=≤0.001 (BMI vs SYNTAX), 0.001 (BMI vs Duke), 0.03 (WHR vs Duke)
Higher BMI is paradoxically associated with less severe angiographic CAD, whereas higher waist-to-hip ratio correlates with greater CAD severity, highlighting the importance of fat distribution over total body mass.
High BMI may not signal worse CAD on angiography; leaves open the obesity paradox and WHR utility pending prospective confirmation.
BACKGROUND: Although for decades there has been controversy regarding the relationship between obesity and coronary artery disease (CAD), it has been assumed that high body mass index (BMI) is a risk factor for CAD. However, the findings of some recent studies were paradoxical. OBJECTIVES: The aim of this study was to find a relationship between high BMI and waist-to-hip ratio (WHR) with severity of CAD. METHODS: This study was a cross-sectional, prospective study where 414 patients with suspected coronary artery disease, in whom coronary angiography was performed, were enrolled. The mean ± SD of their ages was 61.2 ± 27.4 years (range 25-84), and 250 (60.4%) were male. Regarding cardiovascular risk factors, 113 (27.3%) patients had a history of diabetes mellitus (DM), 162 (39.1%) had hypercholesterolaemia, 238 (57.4%) had hypertension, 109 (26.3%) were current smokers and 24 (5.8%) had a family history of CAD. The mean ± SD of the patients' BMI was 26.04 ± 4.08 kg/m(2) (range 16-39) and means ± SD of their WHR ranged from 0.951 ± 0.07 to 0.987 ± 0.05. The mean ± SD of the severity of CAD according to the SYNTAX and Duke scores were 17.7 ± 9.6 (range 0-64) and 3.2 ± 1.7 (range 0-12), respectively. RESULTS: In this study, findings showed a negative correlation between the severity of CAD and BMI, according to both SYNTAX and Duke scores (p ≤ 0.001 and p = 0.001, respectively). However, there was a positive correlation between WHR and severity of CAD, according to the Duke score (p = 0.03). CONCLUSION: BMI had a negative correlation with the severity of CAD, but waist-to-hip ratio had a positive correlation with severity of CAD.
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Parsa et al. (2015) conducted a cross-sectional in Suspected coronary artery disease (n=414). Body mass index (BMI) and waist-to-hip ratio (WHR) was evaluated on Severity of CAD according to SYNTAX and Duke scores (p=≤0.001 (BMI vs SYNTAX), 0.001 (BMI vs Duke), 0.03 (WHR vs Duke)). Body mass index had a negative correlation with the severity of coronary artery disease (p≤0.001), whereas waist-to-hip ratio had a positive correlation with disease severity (p=0.03).
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